• Fever (83-99%)
• Cough (59-82%)
• Fatigue (44-70%)
• Anorexia (20-84%)
• SOB (31-40%)
• Myalgia (11-35%)
• Others: anosmia, loss of taste, GI, headache
Who gets Long Covid-19?
• Factors that appear to be associated with a greater risk of suffering from
“Long COVID-19” appear to be:
• Increasing age
• Excess weight/ obesity
• DM-2 ,COPD,CKD
• Patients on immunosuppression medication ,organ transplant recipients
• Multiple symptoms at presentation
• May be treated symptomatically with Paracetamol or non-steroidal antiinflammatory drugs.
• Monitoring functional status in post-acute coivd-19 patients is not yet an
Chest pain is common in post-acute covid-19 syndrome approximate
incidence 12 to 44 %. The clinical priority is to separate musculoskeletal
and other non-specific chest pain from serious cardiovascular conditions.
Cardiopulmonary complications include myocarditis, pericarditis, myocardial
infarction, dysrhythmias, and pulmonary embolus; they may present
several weeks after acute covid-19. They are commoner in patients with
pre-existing cardiovascular disease
• chronic cough as one that persists beyond eight weeks. Up to that time,
and unless there are signs of super-infection or other complications such
as painful pleural inflammation, cough seems to be best managed with
simple breathing control exercises and medication where indicated.
• Covid-19 is an inflammatory and hypercoagulable state, with an increased
risk of thromboembolic events.
• Many hospitalized patients receive prophylactic anticoagulation.
• If the patient has been diagnosed with a thrombotic episode,
anticoagulation and further investigation and monitoring should follow
• Ischemic stroke, seizures, encephalitis, and cranial neuropathies have
been described after covid-19, but these all seem to be rare.
• A patient suspected of these serious complications should be referred to a
• Common non-specific neurological symptoms, which seem to co-occur
with fatigue and breathlessness, include headaches, dizziness, and
cognitive blunting (“brain fog”).
• A degree of breathlessness is common after acute covid-19. Severe
breathlessness, which is rare in patients who were not Hospitalised,may
require urgent referral. Breathlessness tends to improve with breathing
• Pulse Oximeters may be extremely useful for assessing and monitoring
respiratory symptoms after covid-19.
• An exertional desaturation test should be performed as part of baseline
assessment for patients whose resting pulse oximeter reading is 96% or
above but whose symptoms suggest exertional desaturation (such as lightheadedness or severe breathlessness on exercise).
• Typically, oxygen saturation (pulse oxymeter) would be a daily reading
taken on a clean, warm finger without nail polish, after resting for 20
minutes; the device should be left to stabilize and the highest reading
obtained should be recorded.
• The profound and prolonged nature of fatigue in some post-acute covid-19patients shares features with chronic fatigue syndrome described after otherserious infections including SARS, MERS, and community acquired pneumonia.
• We found no published research evidence on the efficacy of eitherpharmacological or non-pharmacological interventions on fatigue after covid-19.
• Patient resources on fatigue management and guidance for clinicians on returnto exercise and graded return to performance for athletes in covid-19 arecurrently all based on indirect evidence.
which may include:
• Energy management – 3 P’s: plan, priorities and pace,
• Anxiety- Re-assure normal for fatigue after viral infection
• Routine Gentle activity within self assessed limitation Physical activity
• Rest and Sleep
• Hydration and nutrition